Healthcare was one of the most important issues for voters heading into elections this week, resulting in a big win for those uninsured as Medicaid expansion was passed in three traditionally red states, including Utah, Nebraska, and Idaho. This will grant another 300,000 uninsured, low-income Americans Medicaid eligibility, making it a total of 36 states including Washington, D.C., that have expanded Medicaid since the Affordable Care Act (ACA), or Obamacare, passed in 2010.
We’re now in the sixth annual ACA enrollment period and those looking for coverage in 2019 will have to enroll by Dec. 15 in most states. Below are some changes you can expect this time around.
No more tax penalty
You will no longer be federally penalized for going without coverage. As part of tax reform legislation that passed last year, Congress did away with the individual mandate starting in 2019. On the state level, Massachusetts, New Jersey, and D.C., still have state mandates through 2019, and Vermont will move forward with an initiative to mandate health coverage in 2020.
More short-term plans are entering the market
There’s an expansion of short-term limited duration (STLD) policies – which are bare-bones policies with limited benefits – becoming available. Policies can be purchased for 6 or 12 months and can be renewed. Those in better health tend to go for this option because they cost less. But health policy experts at the Henry J. Kaiser Family Foundation warn that these plans are loosely regulated and less standardized than ACA plans, and people with pre-existing conditions will be denied coverage.
“Every claim could be a surprise medical bill,” says Karen Pollitz, a senior fellow at Kaiser Family Foundation. She warns of some short-term policies that only cover doctors visits and hospitalization, others that only cover a maximum of three doctor visits, or some that don’t offer provider networks and outpatient prescription drug policies. And those denied coverage on these short-term plans will not be eligible for the special enrollment period on the health care exchange.
Premiums will increase
After years of uncertainty, the marketplace has proven to be a success; insurance companies are no longer fleeing, and in fact, dozens are coming aboard or returning for 2019. But despite the fact that insurance companies have seen an increase in profitability and a decline in medical claims, premiums are still expected to go up because without an individual mandate, more people are leaving the marketplace and some are looking into the short-term options that can be purchased on non-group market and through associations.
During a recent briefing hosted by the Kaiser Family Foundation, Cynthia Cox, study director for the health insurance and private insurance, said insurers are raising premiums by an average of 16% in 2019, both on and off the exchanges, to make up for the combined loss they expect from the impact of policy changes.
In 2018, of the 14.4 million who bought plans on the marketplace, 9.2 million were receiving subsidies. Next year, those eligible for subsidies will not be as affected by the price increases, but close to 4 million Americans will be hit hardest.
Don’t wait to sign up
Nearly 1 in 5 federal marketplace enrollees auto-renewed for 2018 coverage. But like every year before this, enrollees are encouraged to shop around because it’s the only way you’ll be able to take advantage of the best coverage for the lowest price. There are fewer federal navigators to help consumers with the process of enrolling. The budget for the program has been cut from $63 million in 2016 to $10 million today. This means longer call center wait times and less in-person assistance.
Jeanie Ahn is a senior reporter and producer at Yahoo Finance, covering personal finance and women in business. Reach out by email firstname.lastname@example.org. Follow her on Twitter.
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This story was originally published on Nov. 7, 2018.